Form R-6922 Composite Partnership Return

State 1 2 3 4 5 6 1 2 3 4 5 6 7 1 Total distributive income for RESIDENT partners included with the Louisiana Composite Partnership Return (Total from Line A of Resident Partners Schedule) 10 Overpayment If Line 9 is greater than Line 5 subtract Line 5 from Line 9 and print the result 11 Amount You Owe If Line 5 is greater than Line 9 subtract Line 9 from Line 5 and print the result 12 Interest 13 Delinquent Filing Penalty 14 Balance Due Louisiana Add Lines 11 12 and 13 above and print the result ) 2 Total amount of income tax paid on behalf of qualified Resident partners with this Composite Partnership filing (Total from Line C of Resident Partners Schedule) 3 Total distributive income for NONRESIDENT partners included with the Louisiana Composite Partnership Return (Total from Line A of Nonresident Partners Schedule) 4 Total amount of income tax paid on behalf of qualified NONRESIDENT partners with this Composite Partnership filing (Total from Line C of Nonresident Partners Schedule) 5 Total tax (Add Lines 2 and 4 and print the result ) 6 Amount paid on your behalf by a composite partnership filing Print the name of the partnership 7 Estimated payments for 2011 8 Amount paid with extension request 9 Total payments (Add Lines 6 7 and 8 and print the result ) A Total distributive income for nonresident partners included with the Louisiana Composite Return (DO NOT NET DISTRIBUTABLE LOSSES) A Total distributive income for resident partners included with the Louisiana Composite Return (DO NOT NET DISTRIBUTABLE LOSSES) Address attached B Tax Rate X 06 C Total amount of income tax paid on behalf of qualified nonresident partners (Multiply the partner s share of Line A by Line B ) C Total amount of income tax paid on behalf of qualified resident partners (Multiply the partner s share of Line A by Line B ) Calender/Fiscal year ending changed mark circle Computation of amount due FOR OFFICE USE ONLY Field flag Income Taxable Period Louisiana Composite Partnership Return Louisiana Composite Partnership Return Louisiana Department of Revenue P O Box 201 Baton Rouge LA 70821 0201 Louisiana Department of Revenue P O Box 201 Baton Rouge LA 70821 0201 Make payment to Louisiana Department of Revenue Do not send cash mark circle Nonresident Partners O Extension O If your name has O If amended return O If final return Off Partner Number Name and address of partner Partner ID number (Social Security Number or Revenue Account Number) Included in Composite Return (Yes/No) Distributable Losses Distributable Income Partner Number Name and address of partner Partner ID number (Social Security Number or Revenue Account Number) Nonresident Partner Agreement Filed (Yes/No) Included in Composite Return (Yes/No) Distributable Losses Distributable Income Partnership Name Partnership Name PLEASE PRINT OR TYPE PLEASE PRINT OR TYPE R 6922 (1/12) R 6922 (1/12) Resident Partners Revenue Account Number Schedule Signature Date (dd/mm/yyyy) Signature of paid preparer other than taxpayer Social Security Number PTIN or FEIN of paid preparer SPEC CODE Summary of tax paid on behalf of partners Under penalties of perjury I declare that I have examined this return including all accompanying documents and to the best of my knowledge and belief it is true correct and complete Declaration of paid preparer is based on all available information You must enter your Louisiana Revenue Account Number here